| NPI | 1922407923 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: HI 2124) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI C-03134) |
| 1041C0700X Social Worker, Clinical (Licence: MI 6801095273) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2023-12-07 |